NPIMap

Organization Active NPI

Soulful Med Spa, LLC Dba Awaken Aesthetics

  • Health Service Clinic/Center
  • Warren, OH
National Provider Identifier
1619821279
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
SOULFUL MED SPA, LLC DBA AWAKEN AESTHETICS
Practice address
3050 Elm Rd NE Ste 2
Warren, OH 44483-2620
Phone
(330) 469-5059
NPI assigned
Feb 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chetna Patel, APRNNPI 1164077434
Title
Owner
Phone
(330) 224-5082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

3050 Elm Rd NE Ste 2
Warren, OH 44483-2620

Mailing address

3050 Elm Rd NE Ste 2
Warren, OH 44483-2620
Phone (330) 469-5059

National Provider Directory

National Provider Directory

Locations

3050 Elm Rd NE
Ste 2
Warren, OH 44483
Phone (330) 469-5059

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1619821279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 ELM RD NE STE 2",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832620",
            "telephone_number": "330-469-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 ELM RD NE STE 2",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832620",
            "telephone_number": "330-469-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULFUL MED SPA, LLC DBA AWAKEN AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "CHETNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-224-5082",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.